Understanding the Cognitive Impact of Early Life Epilepsy

癫痫是一种远不止癫痫发作的疾病，癫痫发作可引起神经网络紊乱，导致广泛的认知和行为障碍。迄今为止，在癫痫领域的大多数工作都集中在机制或预防致命事件本身。我实验室的研究重点是早期癫痫发作对大脑发育和癫痫发生的影响。目前的建议扩展了我们的工作，以确定这些机制是否也会引起可能导致早期生活中表现出认知功能障碍的改变，如自闭症。有临床证据表明，早期癫痫发作可能是自闭症的众多先例之一，而癫痫在自闭症患者中很常见，这表明这两个过程之间存在相互作用。我们之前和最近的研究表明，至少在基线突触可塑性增强的未成熟大脑中，癫痫发作似乎直接激活了特定的可塑性相关信号通路。我们假设癫痫引起的可塑性异常？可能会阻断正常的认知可塑性，并导致突触发育的异常模式，类似于自闭症和其他形式的神经发育迟缓。利用电生理技术，我们将首先研究癫痫引起的未成熟大脑正常突触可塑性中断的时间过程。然后，我们将确定与自闭症相关的特定活动依赖信号异常是否会在未成熟的大脑癫痫发作后重新发生。接下来，我们将确定癫痫诱发它们激活的机制，并测试癫痫后干预是否会减弱神经元网络结构和功能的改变。最后，我们将确定在癫痫发作后的人类组织中，以及在新生儿或婴儿癫痫发作相关的自闭症病例中，是否也观察到类似的信号、调节和突触蛋白的改变。

Epilepsy is a disorder that involves far more than the occurrence of seizures, and seizures can cause neuronal network disturbances that result in a wide range of cognitive and behavioral impairment. To date, most work in the epilepsy field has centered on the mechanism or prevention of the ictal events themselves. The focus of my laboratory has been on the impact of early life seizures on brain development and epileptogenesis. The present proposal extends our work to determine whether these mechanisms also induce alterations that could lead to cognitive dysfunction manifesting in early life, such as autism. There is clinical evidence that early life seizures may be one of many precedents for autism, and epilepsy is common in patients with autism, suggesting an interaction between the two processes. Our prior and recent work suggests that at least in the immature brain, where baseline synaptic plasticity is enhanced, seizures appear to directly activate specific plasticity-associated signaling pathways. We hypothesize that seizure induced ?dysplasticity? may occlude normal plasticity involved in cognition, and induce abnormal patterns of synapse development similar to those observed in autism and other forms of neurodevelopmental delay. Using electrophysiological techniques, we will first examine the time course of seizure-induced interruption of normal synaptic plasticity in the immature brain. We will then determine whether specific activity-dependent signaling abnormalities known to be associated with autism occur de novo following seizures in the immature brain. Next, we will identify seizure induced mechanisms for their activation and test whether post-seizure intervention attenuates the altered structure and function of neuronal networks. Finally, we will determine whether similar alterations in signaling, regulatory, and synaptic proteins also are observed in human tissue following seizures and in cases of autism associated with neonatal or infantile seizures.